Combined reflectance confocal microscopy/optical coherence tomography imaging for skin burn assessment

ZnO nanomaterials target mitochondrial apoptosis and mitochondrial autophagy pathways in cancer cells

In recent years, the application of engineering nanomaterials has significantly contributed to the development of various biomedical fields. Zinc oxide nanomaterials (ZnO NMts) have gained wide popularity due to their biocompatibility, unique physical and chemical properties, stability, and cost-effectiveness for large-scale production. They have emerged as potential materials for anticancer applications. This article provides a comprehensive review of the synthesis methods of ZnO NMts and highlights the advantages of combining ZnO NMts with anticancer drugs as a nano platform for cancer treatment. Additionally, the article briefly explains the mechanism of action of ZnO NMts in tumor cells, focusing on the mitochondrial pathways that target cell apoptosis and autophagy. It is observed that these pathways are primarily influenced by reactive oxygen species generated through oxidative stress. The article discusses the promising prospects of ZnO NMts combined with anticancer drugs in the field of cancer medicine and emphasizes the need for further in-depth research on the mitochondrial apoptosis and mitochondrial autophagy pathways.

Miniature side-view dual axes confocal endomicroscope for repetitive in vivo imaging

A side-view dual axes confocal endomicroscope is demonstrated that can be inserted repetitively in hollow organs of genetically engineered mice for in vivo real-time imaging in horizontal and vertical planes. Near infrared (NIR) excitation at λex = 785 nm was used. A monolithic 3-axis parametric resonance scan mirror was fabricated using micro-electro-mechanical systems (MEMS) technology to perform post-objective scanning in the distal end of a 4.19 mm diameter instrument. Torsional and serpentine springs were designed to "switch" the mode of imaging between vertical and horizontal planes by tuning the actuation frequency. This system demonstrated real-time in-vivo images in horizontal and vertical planes with 310 µm depth and 1.75 and 7.5 µm lateral and axial resolution. Individual cells and discrete mucosal structures could be identified.

Comparison of denoising tools for the reconstruction of nonlinear multimodal images

Biophotonic multimodal imaging techniques provide deep insights into biological samples such as cells or tissues. However, the measurement time increases dramatically when high-resolution multimodal images (MM) are required. To address this challenge, mathematical methods can be used to shorten the acquisition time for such high-quality images. In this research, we compared standard methods, e.g., the median filter method and the phase retrieval method via the Gerchberg-Saxton algorithm with artificial intelligence (AI) based methods using MM images of head and neck tissues. The AI methods include two approaches: the first one is a transfer learning-based technique that uses the pre-trained network DnCNN. The second approach is the training of networks using augmented head and neck MM images. In this manner, we compared the Noise2Noise network, the MIRNet network, and our deep learning network namely incSRCNN, which is derived from the super-resolution convolutional neural network and inspired by the inception network. These methods reconstruct improved images using measured low-quality (LQ) images, which were measured in approximately 2 seconds. The evaluation was performed on artificial LQ images generated by degrading high-quality (HQ) images measured in 8 seconds using Poisson noise. The results showed the potential of using deep learning on these multimodal images to improve the data quality and reduce the acquisition time. Our proposed network has the advantage of having a simple architecture compared with similar-performing but highly parametrized networks DnCNN, MIRNet, and Noise2Noise.

Automatic quantitative analysis of structure parameters in the growth cycle of artificial skin using optical coherence tomography

SIGNIFICANCE

Artificial skin (AS) is widely used in dermatology, pharmacology, and toxicology, and has great potential in transplant medicine, burn wound care, and chronic wound treatment. There is a great demand for high-quality AS product and a non-invasive detection method is highly desirable.

AIM

To quantify the constructure parameters (i.e., thickness and surface roughness) of AS samples in the culture cycle and explore the growth regularities using optical coherent tomography (OCT).

APPROACH

An adaptive interface detection algorithm is developed to recognize surface points in each A-scan, offering a rapid method to calculate parameters without constructing OCT B-scan pictures and further achieving realizing real-time quantification of AS thickness and surface roughness. Experiments on standard roughness plates and H&E-staining microscopy were performed as a verification.

RESULTS

As applied on the whole cycle of AS culture, our method's results show that during the air-liquid culture, the surface roughness of the skin first decreases and then exhibits an increase, which implies coincidence with the degree of keratinization under a microscope. And normal and typical abnormal samples can be differentiated by thickness and roughness parameters during the culture cycle.

CONCLUSIONS

The adaptive interface detection algorithm is suitable for high-sensitivity, fast detection, and quantification of the interface with layered characteristic tissues, and can be used for non-destructive detection of the growth regularity of AS sample thickness and roughness during the culture cycle.

OCT-Based Angiography and Surface Topography in Burn-Damaged Skin

BACKGROUND AND OBJECTIVES

There is a clinical need for an accurate, non-invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing.

STUDY DESIGN/MATERIALS AND METHODS

This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in-house-built, clinical-prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes.

RESULTS

En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001).

CONCLUSIONS

OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography

Accurate and timely assessment of the severity of burn is essential for the treatment of burns. Currently, although most first-degree and third-degree burns are easily diagnosed through visual inspection or auxiliary diagnostic methods, the second-degree burn is still difficult to distinguish due to the ambiguity boundaries of second-degree with first-degree and third-degree burns. In this study, we proposed a non-invasive technique by combing photoacoustic imaging (PAI) and optical coherence tomography (OCT) to multi-parameter quantitatively assess the burns. The feasibility and capacity of the dual-mode PAT/OCT for assessing the burns was first testified by tissue-mimicking phantom and burn wounds in mouse pinna in vivo. The further experiments conducted on the back of rats showed that the changes in skin scattering structure, vascular morphology and blood flow provided by the dual-mode PAI/OCT system can determine distinct boundaries and depth of the burns. The experimental results prove that combined PAI/OCT as a novel method can be used to assess the severity of burn, which has the potential to diagnose the burns in clinic.

Optical coherence tomography modeling incorporating scattering, absorption, and multiple reflections

A direct scattering optical coherence tomography forward model was developed to simulate A-scans for both idealized and real light sources on an arbitrary given sample structure. Previous models neglected absorption, scattering, and multiple reflections at interfacial layers, and so two extended models were developed to investigate the impact of these processes. The first model uses the Beer-Lambert law to incorporate both absorption and scattering optical processes, and the second model uses a recursive form to model multiple reflections. These models were tested on a structure representative of a multilayered skin sample. The results show that the absorption and scattering processes have significant impact on the height of the peaks in the simulated A-scans. Conversely, the incorporation of multiple reflections has very little impact on the height of these peaks. Neither of the above processes has any impact on the locations of the A-scan peaks, which are associated with the sample interfaces between layers.

Dual-axis confocal microscopy for point-of-care pathology

Dual-axis confocal (DAC) microscopy is an optical imaging modality that utilizes simple low-numerical aperture (NA) lenses to achieve effective optical sectioning and superior image contrast in biological tissues. The unique architecture of DAC microscopy also provides some advantages for miniaturization, facilitating the development of endoscopic and handheld DAC systems for in vivo imaging. This article reviews the principles of DAC microscopy, including its differences from conventional confocal microscopy, and surveys several variations of DAC microscopy that have been developed and investigated as non-invasive real-time alternatives to conventional biopsy and histopathology.

In vivo confocal laser scanning microscopy imaging of skin inflammation: Clinical applications and research directions

In vivo confocal laser scanning microscopy (CLSM) is a novel imaging technique that provides noninvasive, morphological characterization of skin structures with a resolution that is very close to that of light microscopy. Moreover, as it allows repeated imaging of the same skin area at different time-points, it is an excellent method for monitoring disease course, response to treatment or specific stimuli and a path to study dynamic phenomena in real-time. To date, two different variants of in vivo CLSM have been authorized in dermatological field, namely the reflectance confocal microscopy predominantly for clinical diagnosis and the fluorescence confocal microscopy mainly for research purposes. This study describes the principles of in vivo CLSM technique, its role in the diagnosis and monitoring of inflammatory skin diseases, as well as some promising research directions to study the dynamics of skin inflammation using this method. In vivo CLSM evaluation of inflammatory dermatoses and of the skin inflammatory component in various diseases has an undoubted potential with broad applications ranging from clinical, morphological to experimental, functional studies involving the skin.

DMSO-Free Cryopreservation of Human Umbilical Cord Tissue

Human umbilical cord represents a source of multipotent stromal cells of a supreme therapeutic potential. The cells can be isolated from either fresh or cryopreserved umbilical cord tissues. DMSO is a cryoprotectant most commonly used for preservation of umbilical cord tissues; however, cyto- and genotoxicity of this compound is evident and well documented. In the present study we performed successful cryopreservation of the umbilical cord tissue using other cryoprotectants: propylene glycol, ethylene glycol, and glycerol. Of these, 1.5 M ethylene glycol and 20% glycerol turned out to be the best in terms of the preservation of living cells within the frozen tissue, early onset of migration of these cells out of the thawed explants, and overall efficacy of multipotent stromal cell isolation. Cryobanking of tissues can improve availability of multiple cell products for medical purposes and promote the development of personalized medicine.

Classification of burn injury using Raman spectroscopy and optical coherence tomography: An ex-vivo study on porcine skin

Accurate depth assessment of burn wounds is a critical task to provide the right treatment and care. Currently, laser Doppler imaging is able to provide better accuracy compared to the standard clinical evaluation. However, its clinical applicability is limited by factors like scanning distance, time, and cost. Precise diagnosis of burns requires adequate structural and functional details. In this work, we evaluated the combined potential of two non-invasive optical modalities, optical coherence tomography (OCT) and Raman spectroscopy (RS), to identify degrees of burn wounds (superficial partial-thickness (SPT), deep partial-thickness (DPT), and full-thickness (FT)). OCT provides morphological information, whereas, RS provides biochemical aspects. OCT images and Raman spectra were obtained from burns created on ex-vivo porcine skin. Algorithms were developed to segment skin region and extract textural features from OCT images, and derive spectral wave features from RS. These computed features were fed into machine learning classifiers for categorization of burns. Histological results obtained from trichrome staining were used as ground-truth. The combined performance of RS-OCT reported an overall average accuracy of 85% and ROC-AUC=0.94, in distinguishing the burn wounds. The significant performance on ex vivo skin motivates to assess the feasibility of combined RS-OCT in in vivo models.

A Hybrid Non-destructive Measuring Method of Three-dimensional Profile of Through Silicon Vias for Realization of Smart Devices

Smart devices have been fabricated based on design concept of multiple layer structures which require through silicon vias to transfer electric signals between stacked layers. Because even a single defect leads to fail of the packaged devices, the dimensions of the through silicon vias are needed to be measured through whole sampling inspection process. For that, a novel hybrid optical probe working based on optical interferometry, confocal microscopy and optical microscopy was proposed and realized for enhancing inspection efficiency in this report. The optical microscope was utilized for coarsely monitoring the specimen in a large field of view, and the other methods of interferometry and confocal microscopy were used to measure dimensions of small features with high speed by eliminating time-consuming process of the vertical scanning. Owing to the importance of the reliability, the uncertainty evaluation of the proposed method was fulfilled, which offers a practical example for estimating the performance of inspection machines operating with numerous principles at semiconductor manufacturing sites. According to the measurement results, the mean values of the diameter and depth were 40.420 µm and 5.954 µm with the expanded uncertainty of 0.050 µm (k = 2) and 0.208 µm (k = 2), respectively.

The Progress in Photoacoustic and Laser Ultrasonic Tomographic Imaging for Biomedicine and Industry: A Review

The current paper reviews a set of principles and applications of photoacoustic and laser ultrasonic imaging, developed in the Laser Optoacoustic Laboratories of ILIT RAS, NUST MISiS, and ILC MSU. These applications include combined photoacoustic and laser ultrasonic imaging for biological objects, and tomographic laser ultrasonic imaging of solids. Principles, algorithms, resolution of the developed methods, and related problems are discussed. The review is written in context of the current state-of-art of photoacoustic and laser ultrasonic imaging.

Aberration-diverse optical coherence tomography for suppression of multiple scattering and speckle

Multiple scattering is a major barrier that limits the optical imaging depth in scattering media. In order to alleviate this effect, we demonstrate aberration-diverse optical coherence tomography (AD-OCT), which exploits the phase correlation between the deterministic signals from single-scattered photons to suppress the random background caused by multiple scattering and speckle. AD-OCT illuminates the sample volume with diverse aberrated point spread functions, and computationally removes these intentionally applied aberrations. After accumulating 12 astigmatism-diverse OCT volumes, we show a 10 dB enhancement in signal-to-background ratio via a coherent average of reconstructed signals from a USAF target located 7.2 scattering mean free paths below a thick scattering layer, and a 3× speckle contrast reduction from an incoherent average of reconstructed signals inside the scattering layer. This AD-OCT method, when implemented using astigmatic illumination, is a promising approach for ultra-deep volumetric optical coherence microscopy.

Optical coherence tomography provides an optical biopsy of burn wounds in children-a pilot study

Thermic injuries are among the most severe injuries in childhood. Burn depth is the most relevant prognostic factor, and still its assessment is both difficult and controversial. This diagnostic uncertainty results in repeated wound assessments over a 10-day period and carries a relevant risk for over- and undertreatment. Precise wound assessment would thus be a significant step toward improved care. Optical coherence tomography (OCT) is a noninvasive laser-based technique with a penetration depth of ∼2  mm. It provides structural images of the skin while dynamic OCT (D-OCT) shows blood vessels. In this study, we investigated burns and scalds in 130 children with OCT and D-OCT to identify patterns of injury related to the depth of the burn wound. OCT and D-OCT images from burned skin differed consistently from normal skin. We observed several not formerly described morphologic patterns associated with burn injuries. Superficial wounds are characterized by a loss of the epidermal layer and a smooth surface. With deeper wounds, surface irregularity, loss of the dermal papillary pattern, disappearance of skin lines, and characteristic changes in the microvascular architecture were observed. This is the first systematic study of D-OCT in the assessment of burn wounds in children. A number of burn-associated patterns of injury were identified. Thus, D-OCT provided an "optical biopsy" of burn wounds that adds significant information about the severity of a burn wound.

Spectrally encoded coherence tomography and reflectometry: Simultaneous en face and cross-sectional imaging at 2 gigapixels per second

Non-invasive biological imaging is crucial for understanding in vivo structure and function. Optical coherence tomography (OCT) and reflectance confocal microscopy are two of the most widely used optical modalities for exogenous contrast-free, high-resolution, three-dimensional imaging in non-fluorescent scattering tissues. However, sample motion remains a critical barrier to raster-scanned acquisition and reconstruction of wide-field anatomically accurate volumetric datasets. We introduce spectrally encoded coherence tomography and reflectometry (SECTR), a high-speed, multimodality system for simultaneous OCT and spectrally encoded reflectance (SER) imaging. SECTR utilizes a robust system design consisting of shared optical relays, scanning mirrors, swept laser and digitizer to achieve the fastest reported in vivo multimodal imaging rate of 2 gigapixels per second. Our optical design and acquisition scheme enable spatiotemporally co-registered acquisition of OCT cross-sections simultaneously with en face SER images for multivolumetric mosaicking. Complementary axial and lateral translation and rotation are extracted from OCT and SER data, respectively, for full volumetric estimation of sample motion with micron spatial and millisecond temporal resolution.

Spectrally encoded coherence tomography and reflectometry: Simultaneous en face and cross-sectional imaging at 2 gigapixels per second

Non-invasive biological imaging is crucial for understanding in vivo structure and function. Optical coherence tomography (OCT) and reflectance confocal microscopy are two of the most widely used optical modalities for exogenous contrast-free, high-resolution, three-dimensional imaging in non-fluorescent scattering tissues. However, sample motion remains a critical barrier to raster-scanned acquisition and reconstruction of wide-field anatomically accurate volumetric datasets. We introduce spectrally encoded coherence tomography and reflectometry (SECTR), a high-speed, multimodality system for simultaneous OCT and spectrally encoded reflectance (SER) imaging. SECTR utilizes a robust system design consisting of shared optical relays, scanning mirrors, swept laser and digitizer to achieve the fastest reported in vivo multimodal imaging rate of 2 gigapixels per second. Our optical design and acquisition scheme enable spatiotemporally co-registered acquisition of OCT cross-sections simultaneously with en face SER images for multivolumetric mosaicking. Complementary axial and lateral translation and rotation are extracted from OCT and SER data, respectively, for full volumetric estimation of sample motion with micron spatial and millisecond temporal resolution.

In vivo automated quantification of thermally damaged human tissue using polarization sensitive optical coherence tomography

Over the decades numerous technologies have been performed for the quantification of skin injuries, but their poor sensitivity, specificity and accuracy limits their applications. Optical coherence tomography (OCT) can be potential tool for the identification but the modern high-speed OCT system acquires huge amount of data, which will be very time-consuming and tedious process for human interpretation. Our proposed method opens the possibility of fully automated quantitative analysis based on morphological features of thermally damaged tissue, which will become biomarker for the removal of non-viable skin. The proposed method is based on multi-level ensemble classifier by dissociating morphological features (A-line, B-scan, phase images) extracted from Polarization Sensitive Optical Coherence Tomography (PS-OCT) images. Our proposed classifier attained the average sensitivity, specificity and accuracy is 92.22%, 87.2% and 92.5%, respectively, in detecting the thermally damaged human skin. Moreover, we show that our classifier is one of the best possible classifier based on features extracted from PS-OCT images, which demonstrates the significance of PS-OCT data in detecting abnormality in human skin.

Combined Pulse-Echo Ultrasound and Multispectral Optoacoustic Tomography With a Multi-Segment Detector Array

The high complementarity of ultrasonography and optoacoustic tomography has prompted the development of combined approaches that utilize the same transducer array for detecting both optoacoustic and pulse-echo ultrasound responses from tissues. Yet, due to the fundamentally different physical contrast and image formation mechanisms, the development of detection technology optimally suited for image acquisition in both modalities remains a major challenge. Herein, we introduce a multi-segment detector array approach incorporating array segments of linear and concave geometry to optimally support both ultrasound and optoacoustic image acquisition. The various image rendering strategies are tested and optimized in numerical simulations and calibrated tissue-mimicking phantom experiments. We subsequently demonstrate real-time hybrid optoacoustic ultrasound image acquisition in a healthy volunteer. The new approach enables the acquisition of high-quality anatomical data by both modalities complemented by functional information on blood oxygenation status provided by the multispectral optoacoustic tomography.

Thermal injury of skin and subcutaneous tissues: A review of experimental approaches and numerical models

Thermal injury to skin and subcutaneous tissue is common in both civilian and combat scenarios. Understanding the change in tissue morphologies and properties and the underlying mechanisms of thermal injury are of vital importance to clinical determination of the degree of burn and treatment approach. This review aims at summarizing the research involving experimental and numerical studies of skin and subcutaneous tissue subjected to thermal injury. The review consists of two parts. The first part deals with experimental studies including burn protocols and prevailing imaging approaches. The second part deals with existing numerical models for burns of tissue and related computational simulations. Based on this review, we conclude that though there is literature contributing to the knowledge of the pathology and pathogenesis of tissue burn, there is scant quantitative information regarding changes in tissue properties including mechanical, thermal, electrical and optical properties as a result of burns that are linked to altered tissue morphology.

Multimodal evaluation of ultra-short laser pulses treatment for skin burn injuries

Thousands of people die every year from burn injuries. The aim of this study is to evaluate the feasibility of high intensity femtosecond lasers as an auxiliary treatment of skin burns. We used an in vivo animal model and monitored the healing process using 4 different imaging modalities: histology, Optical Coherence Tomography (OCT), Second Harmonic Generation (SHG), and Fourier Transform Infrared (FTIR) spectroscopy. 3 dorsal areas of 20 anesthetized Wistar rats were burned by water vapor exposure and subsequently treated either by classical surgical debridement, by laser ablation, or left without treatment. Skin burn tissues were non-invasively characterized by OCT images and biopsied for further histopathology analysis, SHG imaging and FTIR spectroscopy at 3, 5, 7 and 14 days after burn. The laser protocol was found as efficient as the classical treatment for promoting the healing process. The study concludes to the validation of femtosecond ultra-short pulses laser treatment for skinburns, with the advantage of minimizing operatory trauma.

Review of near-infrared methods for wound assessment

Wound management is a challenging and costly problem that is growing in importance as people are living longer. Instrumental methods are increasingly being relied upon to provide objective measures of wound assessment to help guide management. Technologies that employ near-infrared (NIR) light form a prominent contingent among the existing and emerging technologies. We review some of these technologies. Some are already established, such as indocyanine green fluorescence angiography, while we also speculate on others that have the potential to be clinically relevant to wound monitoring and assessment. These various NIR-based technologies address clinical wound management needs along the entire healing trajectory of a wound.

In vivo optical interferometric imaging of human skin utilizing monochromatic light source

We have demonstrated tomographic imaging of in vivo human skin with an optical interferometric imaging technique using a monochromatic light source. The axial resolution of this method is determined by the center wavelength and the NA of the objective and is irrelevant to the bandwidth of the light source in contrast to optical coherence tomography. Our imaging system is constructed with low-priced and small-sized compact disk optical pickup components, a laser diode, a high NA objective, and a voice coil actuator. In spite of its low cost and small size, our imaging system can visualize the structure of human skin as clearly as a commercial reflectance confocal microscope.

Tri-modal microscope for head and neck tissue identification

A novel tri-modal microscope combining optical coherence tomography (OCT), spectrally encoded confocal microscopy (SECM) and fluorescence imaging is presented. This system aims at providing a tool for rapid identification of head and neck tissues during thyroid surgery. The development of a dual-wavelength polygon-based swept laser allows for synchronized, co-registered and simultaneous imaging with all three modalities. Further ameliorations towards miniaturization include a custom lens for optimal compromise between orthogonal imaging geometries as well as a double-clad fiber coupler for increased throughput. Image quality and co-registration is demonstrated on freshly excised swine head and neck tissue samples to illustrate the complementarity of the techniques for identifying signature cellular and structural features.

Femtosecond pulsed laser ablation to enhance drug delivery across the skin

Laser poration of the skin locally removes its outermost, barrier layer, and thereby provides a route for the diffusion of topically applied drugs. Ideally, no thermal damage would surround the pores created in the skin, as tissue coagulation would be expected to limit drug diffusion. Here, a femtosecond pulsed fiber laser is used to porate mammalian skin ex vivo. This first application of a hollow core negative curvature fiber (HC-NCF) to convey a femtosecond pulsed, visible laser beam results in reproducible skin poration. The effect of applying ink to the skin surface, prior to ultra-short pulsed ablation, has been examined and Raman spectroscopy reveals that the least, collateral thermal damage occurs in inked skin. Pre-application of ink reduces the laser power threshold for poration, an effect attributed to the initiation of plasma formation by thermionic electron emission from the dye in the ink. Poration under these conditions significantly increases the percutaneous permeation of caffeine in vitro. Dye-enhanced, plasma-mediated ablation of the skin is therefore a potentially advantageous approach to enhance topical/transdermal drug absorption. The combination of a fiber laser and a HC-NCF, capable of emitting and delivering femtosecond pulsed, visible light, may permit a compact poration device to be developed.

Multimodal Imaging Spectroscopy of Tissue

Advanced optical imaging technologies have experienced increased visibility in medical research, as they allow for a label-free and nondestructive investigation of tissue in either an excised state or living organisms. In addition to a multitude of ex vivo studies proving the applicability of these optical imaging approaches, a transfer of various modalities toward in vivo diagnosis is currently in progress as well. Furthermore, combining optical imaging techniques, referred to as multimodal imaging, allows for an improved diagnostic reliability due to the complementary nature of retrieved information. In this review, we provide a summary of ongoing multifold efforts in multimodal tissue imaging and focus in particular on in vivo applications for medical diagnosis. We also discuss the advantages and potential limitations of the imaging methods and outline opportunities for future developments.

Feasibility of ablative fractional laser-assisted drug delivery with optical coherence tomography

Fractional resurfacing creates hundreds of microscopic wounds in the skin without injuring surrounding tissue. This technique allows rapid wound healing owing to small injury regions, and has been proven as an effective method for repairing photodamaged skin. Recently, ablative fractional laser (AFL) treatment has been demonstrated to facilitate topical drug delivery into skin. However, induced fractional photothermolysis depends on several parameters, such as incident angle, exposure energy, and spot size of the fractional laser. In this study, we used fractional CO2 laser to induce microscopic ablation array on the nail for facilitating drug delivery through the nail. To ensure proper energy delivery without damaging tissue structures beneath the nail plate, optical coherence tomography (OCT) was implemented for quantitative evaluation of induced microscopic ablation zone (MAZ). Moreover, to further study the feasibility of drug delivery, normal saline was dripped on the exposure area of fingernail and the speckle variance in OCT signal was used to observe water diffusion through the ablative channels into the nail plate. In conclusion, this study establishes OCT as an effective tool for the investigation of fractional photothermolysis and water/drug delivery through microscopic ablation channels after nail fractional laser treatment.

In vivo analysis of burns in a mouse model using spectroscopic optical coherence tomography

Spectroscopic analysis of biological tissues can provide insight into changes in structure and function due to disease or injury. Depth-resolved spectroscopic measurements can be implemented for tissue imaging using optical coherence tomography (OCT). Here, spectroscopic OCT is applied to in vivo measurement of burn injury in a mouse model. Data processing and analysis methods are compared for their accuracy. Overall accuracy in classifying burned tissue was found to be as high as 91%, producing an area under the curve of a receiver operating characteristic curve of 0.97. The origins of the spectral changes are identified by correlation with histopathology.

Noncontact imaging of burn depth and extent in a porcine model using spatial frequency domain imaging

The standard of care for clinical assessment of burn severity and extent lacks a quantitative measurement. In this work, spatial frequency domain imaging (SFDI) was used to measure 48 thermal burns of graded severity (superficial partial, deep partial, and full thickness) in a porcine model. Functional (total hemoglobin and tissue oxygen saturation) and structural parameters (tissue scattering) derived from the SFDI measurements were monitored over 72 h for each burn type and compared to gold standard histological measurements of burn depth. Tissue oxygen saturation (stO₂) and total hemoglobin (ctHbT) differentiated superficial partial thickness burns from more severe burn types after 2 and 72 h, respectively (p < 0.01), but were unable to differentiate deep partial from full thickness wounds in the first 72 h. Tissue scattering parameters separated superficial burns from all burn types immediately after injury (p < 0.01), and separated all three burn types from each other after 24 h (p < 0.01). Tissue scattering parameters also showed a strong negative correlation to histological burn depth as measured by vimentin immunostain (r² > 0.89). These results show promise for the use of SFDI-derived tissue scattering as a correlation to burn depth and the potential to assess burn depth via a combination of SFDI functional and structural parameters.

Design and characterization of a handheld multimodal imaging device for the assessment of oral epithelial lesions

A compact handpiece combining high resolution fluorescence (HRF) imaging with optical coherence tomography (OCT) was developed to provide real-time assessment of oral lesions. This multimodal imaging device simultaneously captures coregistered en face images with subcellular detail alongside cross-sectional images of tissue microstructure. The HRF imaging acquires a 712 × 594 μm² field-of-view at the sample with a spatial resolution of 3.5 μm. The OCT images were acquired to a depth of 1.5 mm with axial and lateral resolutions of 9.3 and 8.0 μm, respectively. HRF and OCT images are simultaneously displayed at 25 fps. The handheld device was used to image a healthy volunteer, demonstrating the potential for in vivo assessment of the epithelial surface for dysplastic and neoplastic changes at the cellular level, while simultaneously evaluating submucosal involvement. We anticipate potential applications in real-time assessment of oral lesions for improved surveillance and surgical guidance.

Noncontact imaging of burn depth and extent in a porcine model using spatial frequency domain imaging

The standard of care for clinical assessment of burn severity and extent lacks a quantitative measurement. In this work, spatial frequency domain imaging (SFDI) was used to measure 48 thermal burns of graded severity (superficial partial, deep partial, and full thickness) in a porcine model. Functional (total hemoglobin and tissue oxygen saturation) and structural parameters (tissue scattering) derived from the SFDI measurements were monitored over 72 h for each burn type and compared to gold standard histological measurements of burn depth. Tissue oxygen saturation (stO₂) and total hemoglobin (ctHbT) differentiated superficial partial thickness burns from more severe burn types after 2 and 72 h, respectively (p < 0.01), but were unable to differentiate deep partial from full thickness wounds in the first 72 h. Tissue scattering parameters separated superficial burns from all burn types immediately after injury (p < 0.01), and separated all three burn types from each other after 24 h (p < 0.01). Tissue scattering parameters also showed a strong negative correlation to histological burn depth as measured by vimentin immunostain (r² > 0.89). These results show promise for the use of SFDI-derived tissue scattering as a correlation to burn depth and the potential to assess burn depth via a combination of SFDI functional and structural parameters.

Monitoring of wound healing process of human skin after fractional laser treatments with optical coherence tomography

Fractional photothermolysis induced by non-ablative fractional lasers (NAFLs) or ablative fractional lasers (AFLs) can remodel the skin, regenerate collagen, and remove tumor tissue. However, fractional laser treatments may result in severe side effects, and multiple treatments are required to achieve the expected outcome. Thus, the treatment outcome and downtime after fractional laser treatments are key issues to determine the following treatment strategy. In this study, an optical coherence tomography (OCT) system was implemented for in vivo studies of wound healing after NAFL and AFL treatments. According to the OCT scanning results, the laser-induced photothermolysis including volatilization and coagulation could be morphologically identified. To continue monitoring the wound healing process, the treated regions were scanned with OCT at different time points, and the en-face images at various tissue depths were extracted from three-dimensional OCT images. Furthermore, to quantitatively evaluate the morphological changes at different tissue depths during wound healing, an algorithm was developed to distinguish the backscattering properties of untreated and treated tissues. The results showed that the coagulation damage induced by the NAFLs could be rapidly healed in 6 days. In contrast, the tissue volatilization induced by AFLs required a longer recovery time of 14 days. In conclusion, this study establishes the feasibility of this methodology as a means of clinically monitoring treatment outcomes and wound healing after fractional laser treatments.